Capital Commentary is the weekly current-affairs publication of CPJ, written to encourage the pursuit of public justice.

Party Leadership and the Fate of Healthcare

Timothy Sherratt


July 17, 2009

When President Obama was inaugurated, he announced a coherent strategy featuring healthcare, energy policy, and education reform. Six months later, that seamless web looks a bit moth-eaten.

The president announced his initiatives as responses to the economic crisis. Universal healthcare would control costs, green energy deliver jobs, and an educated workforce raise American competitiveness. Taken together, the three solutions sounded the same note of economic responsibility to offset the high costs of securing any one of them. But it is hard to sustain a sense of urgency month after month, all the more so when issues are turned over to Congress and the president offers ambivalent party leadership.

Mr. Obama led from the front on climate control and energy and the result was House passage of a bill containing significant reductions in greenhouse gas emissions via a national cap-and-trade system, and provision for power companies to produce fifteen percent of electricity from wind and solar energy. An impressive accomplishment, the bill showed just how important the president’s leadership was. It passed by a single vote, despite the Democrats’ 77-seat advantage and repeated interventions from the president himself.

On healthcare, mindful of the Clintons’ over-investment in their own design, Obama has been more circumspect and has not insisted that Democrats adopt his choice of a bill. His approach may have backfired. Already, senators have warned that Congress will not meet its August deadline, which may deny the president an October signing.

Politically speaking, healthcare reform revolves around three issues: choice, cost, and coverage. Stress one and you invite complaints that you are ignoring the others. The president emphasizes universal coverage and cost containment. Universal coverage is no less a matter of dignity than choice and no less a matter of responsibility than cost containment, but coverage is overshadowed by the economic fears that lend urgency to cost containment and by the cultural heft that American individualism lends to choice.

The most successful healthcare reform thus far—in Massachusetts—made coverage a priority. That reform enjoyed the advantage of a relatively small pool of uninsured residents, was promoted by advertising that stressed individual choice (to sweeten the law’s coverage mandate), and has met most criticisms of its relative inattention to cost containment. Those conditions do not apply at the national level.

The Republicans, though still reeling from last year’s defeat and all but leaderless nationally, have begun to smell blood, and for the first time since November it’s not theirs. Healthcare reform provides opportunities to bash the Democrats’ statist instincts and for Republicans to pose as defenders of choice.

Congressional Democrats lack sufficient cohesion to guarantee support for bills that may emerge and such cohesion as exists will fade as the 2010 elections approach.

For all these reasons, President Obama will have to provide strong party leadership to prevent healthcare legislation dying the death of a thousand qualifications.

As for education, the third leg of the Big Plan, little progress has been made. This may have as much to do with education being chiefly a state government responsibility as with any lack of desire on the president’s part to press reform. So the president has stood on the sidelines urging reform of community colleges and calling for more charter schools, while education secretary Arne Duncan deploys stimulus money as a mix of carrot and stick to nudge the states along.

Is the president still learning the inside game of politics? Perhaps. Certainly the trans-partisan rhetoric Mr. Obama reveled in during the campaign will not help him exercise the party leadership he urgently needs to provide now. If he wants to avoid defeat on the centerpiece of his legislative program, it’s time for him to practice consistent party leadership.

—Timothy Sherratt, Professor of Political Studies
    Gordon College

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Capital Commentary is a weekly current-affairs publication of the Center for Public Justice. Published since 1996, it is written to encourage the pursuit of justice. Commentaries do not necessarily represent an official position of the Center for Public Justice but are intended to help advance discussion. Articles, with attribution, may be republished according to our publishing guidelines.”